Clinical Studies and Case Reports

On this site you will find clinical studies with cannabis or single cannabinoids in different diseases and case reports on the use of cannabis by patients.
You may search for diseases (indications), authors, medication, study design (controlled study, open trial, case report etc.) and other criteria.

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TitleThe effect of orally and rectally administered delta-9-tetrahydrocannabinol on spasticity: a pilot study with 2 patients.
Author(s)Brenneisen R, Egli A, Elsohly MA, Henn V, Spiess Y
Journal, Volume, IssueInternational Journal of Clinical Pharmacology and Therapeutics 1996;34(10):446-552
Major outcome(s)improvement of joint function and ability to walk; in 1 patient additional alleviation of pain
IndicationMultiple sclerosis; Spinal cord injury; Spasticity; PainAbstract

Multiple doses of delta 9-tetrahydrocannabinol (THC) capsules (Marinol) and THC hemisuccinate suppositories were administered in 24- hour intervals to 2 patients with organically caused spasticity. After oral doses of 10-15 mg THC, peak plasma levels from 2.1 to 16.9 ng/ml THC and 74.5 to 244.0 ng/ml 11-nor-9-carboxy-delta 9- tetrahydrocannabinol (THC-COOH, major THC metabolite) were measured by GC/MS within 1-8 h and 2-8 h, respectively. After rectal doses of 2.5-5 mg THC, peak plasma levels from 1.1 to 4.1 ng/ml THC and 6.1 to 42.0 ng/ml THC-COOH were measured within 2-8 h and 1-8 h, respectively. The bioavailability resulting from the oral formulation was 45-53% relative to the rectal route of administration, due to a lower absorption and higher first-pass metabolism. The effect of THC on spasticity, rigidity, and pain was estimated by objective neurological tests (Ashworth scale, walking ability) and patient self- rating protocols. Oral and rectal THC reduced at a progressive stage of illness the spasticity, rigidity, and pain, resulting in improved active and passive mobility. The relative effectiveness of the oral vs. the rectal formulation was 25-50%. Physiological and psychological parameters were used to monitor psychotropic and somatic side-effects of THC. No differences in the concentration ability, mood, and function of the cardiovascular system could be observed after administration of THC.

Route(s)Oral; Rectal
Dose(s)10-15 mg oral; 2,5-5 mg rectal
Duration (days)
Type of publication
Address of author(s)Institute of Pharmacy, University of Bern, Switzerland
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